Regulatory Operations Analyst II
The candidate performs regulatory filings for the commercial markets and/or performs policy research and issue advocacy. Performs formal regulatory filings seeking approval of new products, service area expansions, new benefit policies and others. Conducts assigned special projects, provide regulatory interpretation, and perform reporting. Will work knowledge of health products, procedures, and state insurance regulations. Have the ability to work independently with all aspects of filing assignments. May attend external conferences and seminars to evaluate industry trends. Demonstrate effective verbal and written communication skills to collaborate with key stakeholders across levels of the organization. Perform regulatory filings in SERFF and HIOS for medium risk states. Draft and revise filing documentation (including Evidence of Coverage, Schedules and SBCs). Review documentation for accuracy. Prepare QHP templates and other supporting documentation for filings. Monitor pending legislation and regulations affecting Centene’s commercial business in medium risk states. Analyze and interpret proposed or enacted legislation and communicate out to impacted departments. Maintain database and other reference materials related to legislative and regulatory issues and compliance. Assist health plans in managing relationships with regulatory agencies and seek to resolve policy issues which may negatively impact service to members. Maintain internal filing trackers. Respond to internal and external requests for information required by the organization for its regulatory filings. Provide Reg Ops management assessments and status of CMS objections. Respond to inquiries from state and federal regulatory agencies. Communicate state and federal requirements to internal and external clients. Assist in the maintenance and implementation of department policies, procedures, and work processes. Assist in the identification, analysis, and resolution of issues. Maintain and review regulatory documentation necessary to maintain corporate standards. Conduct research projects to analyze, interpret and disseminate guidance on legal, contractual and regulatory requirements for assigned states. Bachelors degree, preferably in Business, Communications, Healthcare, Political Science/ Pre-Law, MA or JD or 1-3 years of regulatory experience, including policy analysis and/ or product filings (CMS and/ or State DOI) required. Experience preferred in commercial health insurance required.
7711 Carondelet Ave
Clayton, MO 63105